Effect of a smoking cessation program on tooth loss: a 24-month prospective study

O objetivo deste estudo foi avaliar o efeito de um programa antitabágico e do tratamento periodontal não-cirúrgico na perda dentária em fumantes portadores de periodontite crônica. Fumantes que desejavam parar de fumar se inscreveram no serviço oferecido pelo Programa de Cessação de Tabagismo do Hospital Universitário em São Paulo. Eles se submeteram a tratamento periodontal não cirúrgico concomitantemente à terapia de cessação de tabagismo. Manutenção periodontal foi realizada a cada três meses até 24 meses de acompanhamento. Um examinador calibrado e cego para o hábito de fumar realizou exame periodontal completo na inclusão dos pacientes e após 3, 6, 12 e 24 meses após o término do tratamento periodontal. Este examinador verificou a perda dentária durante o período de acompanhamento. Durante os 24 meses no estudo, a decisão da extração dentária era tomada por um consenso de três periodontistas do grupo de pesquisa. Dos 1.214 pacientes inscritos, 306 foram examinados, 112 foram incluídos e 59 continuaram no estudo por dois anos. Destes, 18 (31%) pararam de fumar e 41 (69%) continuaram fumando ou oscilaram. A média geral do número de dentes perdidos foi 0,63 (±1,4). Após ajustar para as extrações realizadas durante a fase de tratamento periodontal, a média diminuiu para 0,42 (± 1,2), sendo 0,39 ± 0,8 no grupo dos que pararam de fumar e 0,44 ± 1,3 no grupo que continuou fumando (p = 0.88). Apesar de a extensão cumulativa e a média dos dentes ausentes terem sido semelhantes nos dois grupos durante o acompanhamento, houve uma tendência de maior perda dentária no grupo fumante no primeiro ano de acompanhamento. Com estes resultados, verificou-se que a cessação to tabagismo não promoveu um benefício adicional na perda dentária em fumantes 24 meses após parar de fumar.The aim of this study was to evaluate the effect of a smoking cessation program and non surgical periodontal treatment on tooth loss in smokers with chronic periodontitis. Smokers willing to quit smoking enrolled in the service offered by the Smoking Cessation Program at the University Hospital in São Paulo. They have undergone non surgical periodontal treatment concomitantly to smoking cessation therapy. Periodontal maintenance was performed every 3 months until 24 months of followup. A calibrated examiner, blinded to smoking status, performed complete periodontal examination on baseline and after 3, 6, 12 and 24 months after periodontal treatment. The examiner assessed tooth loss during follow-up. During the 24 months of follow-up, the decision to extract a tooth was taken by a consensus of 3 periodontists of the study group. Of the 1,214 enrolled patients, 306 were examined, 112 were included and 59 remained in the study for two years. Of these, 18 (31%) quit smoking and 41 (69%) continued to smoke or oscillated. The mean number of tooth lost was 0.63 (±1.4). After adjusting for the extractions performed during the treatment phase, the mean number decreased to 0.42 (±1.2), being 0.39 ± 0.8 in the quitters group and 0.44 ± 1.3 in the group the continued to smoke (p=0.88). Even though the cumulative extent and mean number of missing teeth were similar in both groups during follow-up, there was a tendency for a higher tooth loss in the smokers group in the first year of follow-up. It was concluded that smoking cessation did not promote an additional benefit on tooth loss in smokers 24 months after smoking cessation

A prospective 12-month study of the effect of smoking cessation on periodontal clinical parameters

P>Aim The aim of this 12-month prospective study was to assess the adjunctive effect of smoking cessation in non-surgical periodontal therapy of subjects with severe chronic periodontitis. Materials and methods Of the 201 subjects enrolled from a smoking cessation clinic, 93 were eligible and received non-surgical periodontal treatment and concurrent smoking cessation treatment. Periodontal maintenance was performed every 3 months. Full-mouth periodontal examination in six sites per tooth was performed by a calibrated examiner, blinded to smoking status, at baseline, 3, 6 and 12 months after non-surgical periodontal treatment. Furthermore, expired air carbon monoxide concentration measurements and interviews based on a structured questionnaire were performed in order to collect demographic and smoking data. Results Of the 93 eligible subjects, 52 remained in the study after 1 year. Of these, 17 quit smoking and 35 continued smoking or oscillated. After 1 year, only quitters presented significant clinical attachment gain (p=0.04). However, there were no differences between the groups regarding clinical attachment level, probing depth, bleeding on probing and plaque index after 1 year (p > 0.05). Conclusion Smoking cessation promoted clinical attachment gain in chronic periodontitis subjects from a smoking cessation clinic after 1 year of follow-up.Sao Paulo Research Foundation (FAPESP)[07/54494-3

Predictors of smoking cessation in smokers with chronic periodontitis: a 24-month study

Abstract The purpose of this 24-month study was to identify predictors of smoking cessation in a cohort of smokers with chronic periodontitis, attending a multidisciplinary smoking cessation program. Of the 286 subjects screened, 116 were included and received non-surgical periodontal treatment and smoking cessation therapy, which consisted of lectures, cognitive behavioral therapy, and pharmacotherapy, according to their individual needs. During initial periodontal treatment, dentists actively motivated the study subjects to stop smoking, using motivational interviewing techniques. Further smoking cessation counseling and support were also provided by the dentists, during periodontal maintenance sessions at 3, 6, 12 and 24 months of follow-up. Smoking status was assessed by means of a structured questionnaire, and was validated by exhaled carbon monoxide (CO) measurements. The Fagerström Test for Cigarette Dependence was used to assess smoking dependence. Of the 61 individuals that remained up to the 24-month examination, 31, 21 and 18 declared that they were not smoking at 3, 12 and 24 months, respectively. Smoking cessation after 24 months was associated with the male gender (OR = 3.77, 95%CI = 1.16–12.30), baseline CO levels less than 10ppm (OR = 5.81, 95%CI 1.76–19.23), not living or working with another smoker (OR = 7.38, 95%CI 1.76–30.98) and a lower mean Fagerström test score (OR = 5.63, 95%CI 1.55–20.43). We concluded that smoking cessation was associated with demographic, smoking history and cigarette dependence variables